Gait Analysis

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Why Gait Analysis ?
Your foot is in contact with the ground
for about 0,8 of a second when walking
Personalized injury rehab
and
about 0,25 of a second when running
Running man
Imagine trying to determine normal or abnormal function of the leg with the naked eye in a quarter of a second. This is to difficult even for the most experienced practitioner
doctor

Dr. Kalika’s experience comes from working with Prof. Pavel Kolar the renowned Czech School of Rehabilitation as well as Prof. Christopher Powers who is one of the worlds leader in treatment and prevention of running injuries. Another unique approach that Dr.Kalika is certified in is ISM (integrated system model) therapy.This approach is now used by most elite EPL soccer teams (Manchester city and Chelsea) to keep their players away from injuries as well as for in season rehabilitation. Dr. Kalika has knowledge not only in several different types of therapy he also has expertise with diagnostic ultrasound, gait and running analysis, orthopedics, and sports medicine. The combination of all these different experiences helps him correctly diagnose and rehabilitate athletes better than most clinics in NYC. Dr. Kalika has also studied under top leading running authorities like Brian Hidershide and Irene Davis. These experiences and extra training has given Dr. Kalika the unique expertise in running performance.

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Despite 10 years of experience with instrumented gait analysis, attending multiple running medicine conferences, certification in clinical biomechanics, and personal experience with Chris Powers, I decided to undertake this additional certification to ensure that no single detail concerning the assessment and treatment of running injuries escapes me.

What Is Gait Analysis?
Kinematics in NYC

Gait is the pattern in which you walk or run: Your personal step by step “cycle”

Gait Analysis is a method for examining the “cycles”, looking for variations, and abnormal movement patterns

The Test Has Several Components:
Gait Kinematics
As the movement of the person walking is recorded by high speed video cameras a reconstructive digital model is created in order to calculate joint motion in each plane.
Gait Kinetics
Kinetics are the forces which act across the joints.
The ground reaction force of each foot strike is measured as the person walks through the force plate. The magnitude of the ground reaction forces can then be calculated during different phases of the gait cycle.
Gait kinetics in clinic
Surface Electromyography (SEMG)
SEMG provides information about how the muscles work during walking. We can use the SEMG data to see how each muscle acts and how it contributes to the gait abnormality.
Surface electromyography (SEMG)
Foot Pressure
Foot pressure is measured during walking through a specialized instrumented treadmill . This enables a visualization of foot mechanics, timing sequence of gait cycles , 3-D pressure distribution and a visualization of center of pressure ( gait line).
How Is Gait Analysis Performed?
The subject walks on the specialized walkway or instrumented treadmill. The markers are tracking motion by multi camera motion capture system . Force plates in the walkway/treadmill gather kinetic data as the subject walks over them . A computer workstation equipped with motion analysis software permits the gait data to be analyzed. After processing the gait analysis , report including video clips of your gait cycles is produced. PICTURE 4 (Picture of subject walking through treadmill).
Gait Analysis in New York
Who Needs Gait Analysis?
Gait analysis is extremely diagnostic for patients with lower extremity problems , patients who have pain during walking or running. People with knee, hip , foot and ankle pain. Athletes and runners. As well as people who have balance and instability issues during walking. Some categories of low back pain patients could also benefit from gait analysis.
Clinical Significance of Gait Analysis

Whether you are an active sportsman, recovering from an injury or simply want to enjoy pain free mobility, gait analysis can provide valuable data for you recovery.
Gait analysis benefits include:

  • Provides biomechanical data about efficiency of your mobility
  • Provides functional reasoning why you have pain
  • It may identify the origin of your pain disorder not explainable by radiological imaging
  • Defines treatment protocols
  • Speeds up rehabilitation
  • Provides objective monitoring of your recovery
  • Can rule in or rule out orthotic prescription by identifying if foot problem comes from faulty mechanics at the hip or at the foot
  • Gait and running analysis Is irreplaceable clinical tool in diagnosis of sport and verse injuries
  • Gait analysis can help to maximize your performance , eliminate biomechanical deficiencies and improve strength
What Pathologies Are Particularly Useful to Diagnose and Treat Utilizing Gait Analysis

All running and overuse conditions of the hip, knee and foot !!!

  • Hip Femora Acetabular Impingement ( FAI)
  • Hip arthritis
  • Hip instability
  • Patellafemoral pain syndrome
  • Osteoarthritis of the knee
  • Tibialis posterior tenon dysfunction
  • Plantar fascitis
  • Peroneal tendinitis
  • Metatarsalgia
  • Medial arch pain
  • Ankle instability
  • Shin splints
  • Stress fractures in the foot or leg
  • Some types of back pain

Clinical Case Studies
NYDNRehab


Case Study: Runner’s Pain

Our patient is a 33 year-old female runner complaining of hamstring and calf tightness, and posterior knee pain in both legs. The pain began in 2015, but she continued to run.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

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Separation of muscle ends due to tear elicited
on dynamic sonography examination

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